Understanding Family Caregiver's Self-Initiated Expressions of Concern: Prevalence, Content, Emotional Implication, and Opportunity for Doctor's Empathic Responses in Chinese Pediatric Primary Care.

Abstract

Despite the significance of patient expressions of concern in medical interaction, existing research has found that doctors often fail to respond to them or even overlook them. Based on a dataset of video-recorded naturally occurring medical conversations in Chinese pediatric primary care, this study aims to systematically investigate the expressions of concern initiated by the family caregivers of pediatric patients and the responses of doctors. The results show that family caregivers actively initiate expressions of concern, covering a wide range of topics. Doctors respond to these concerns in 68.8% of the cases, while the rest are interrupted, ignored, or minimally acknowledged. In addition, as commonly found in other clinical and cultural contexts, family caregivers rarely express their emotional distress explicitly but rather indicate their underlying emotions implicitly. These findings suggest that a better understanding of the full range of family caregiver's self-initiated expressions of concern and their complexities provide important opportunities for doctors to identify and respond to them empathically.